SUMMARY: In this study, 5,092 people (ages 65 or older) were screened for dementia. Out of this group, 1,002 participants (329 with dementia and 673 without dementia) were given comprehensive neuropsychiatric (relating to the nervous system, mental and emotional condition) examination. The participants were then evaluated on the basis of a recognized method for investigating and determining dementia-associated disturbance. Of the participants with dementia, 65% had Alzheimer’s disease, 19% had vascular dementia, and 16% had another dementia diagnosis. Individuals with dementia were four times more likely to exhibit such disorders than those without. Subjects with Alzheimer’s disease were more prone to delusions but less likely to suffer from depression. The authors of this study conclude that the majority of individuals with dementia also exhibit a broad spectrum of other dementia-related problems.
OBJECTIVE: The authors report findings from a study of 5,092 community residents who constituted 90% of the elderly resident population of Cache County, Utah.
METHOD: The 5,092 participants, who were 65 years old or older, were screened for dementia. Based on the results of this screen, 1,002 participants (329 with dementia and 673 without dementia) underwent comprehensive neuropsychiatric (relating to the nervous system as well as mental and emotional disorders) examinations and were rated on the Neuropsychiatric Inventory, a widely used method for ascertainment and classification of dementia-associated mental and behavioral disturbances.
RESULTS: Of the 329 participants with dementia, 214 (65%) had Alzheimer’s disease, 62 (19%) had vascular dementia, and 53 (16%) had another DSM-IV dementia diagnosis; 201 (61%) had exhibited one or more mental or behavioral disturbances in the past month. Apathy (27%), depression (24%), and agitation/aggression (24%) were the most common in participants with dementia. These disturbances were almost four times more common in participants with dementia than in those without. Only modest differences were observed in the prevalence of mental or behavioral disturbances in different types of dementia or at different stages of illness: participants with Alzheimer’s disease were more likely to have delusions and less likely to have depression. Agitation/aggression and aberrant motor behavior were more common in participants with advanced dementia.
CONCLUSIONS: On the basis of their findings in this large community population of elderly people, the authors conclude that a wide range of dementia-associated mental and behavioral disturbances afflict the majority of individuals with dementia. Because of their frequency and their adverse effects on patients and their caregivers, these disturbances should be ascertained and treated in all cases of dementia.
Source: Am J Psychiatry 2000 May 1;157(5):708-714